Injury Histories Hamper Some N.F.L. Prospects

The New York Times—April 25, 2009

An analysis published in the April issue of The American Journal of Sports Medicine indicates that players injured in college play may be riskier draft picks than most realize. The study, co-written by medical personnel from two N.F.L. teams, found that certain injury histories among players at certain positions — however healed — probably hamper their ability to play in the N.F.L.

No injury is good. But linebackers have particular difficulty recovering from torn anterior cruciate ligaments. Old shoulder damage tends to hold back linemen on both sides. And defensive backs with a history of meniscus problems in a knee have fared considerably worse than those without it.

The doctors asserted that the relationships were strong enough for teams to consider them when making draft picks.

“It gives us some insight into what injuries really do impact a player, the common things that we’ve seen,” said Dr. Scott A. Rodeo, one of six co-authors of the study. He is an orthopedic surgeon at Hospital for Special Surgery in New York and an associate team physician for the Giants. “We go to so much effort to examine these players — does it matter?”

The doctors analyzed the orthopedic histories of more than 5,000 players who attended the N.F.L. combine, where promising collegians gather in Indianapolis to be examined and scouted by all teams at once, from 1987 through 2000.

This year’s combine discovered a stress fracture in the foot of the top receiver Michael Crabtree. But the published study suggests that even injuries that have seemed healed for years can still negatively affect players at certain positions.

Injuries to a knee’s anterior cruciate ligament hurt defensive linemen and linebackers more than could be ascribed to random fluctuation. Linemen with the injury played at least one N.F.L. game 54 percent of the time, compared with 67 percent for those without it; linebackers’ rate of making the league decreased to 48 percent from 64 percent.

Dr. Robert H. Brophy, the study’s lead author, who completed a fellowship in sports medicine at Hospital for Special Surgery and is now an assistant professor at the Washington University School of Medicine in St. Louis, speculated that this and other links between certain positions and injuries might be ascribed to the physical demands of playing those positions. He said that defensive linemen might demand even more than the average player from the A.C.L., which is the primary stabilizer in the knee.

“On the offensive line, they generally know where they need to go, whereas the defense is reactive,” said Brophy, who also serves as an assistant team physician with the St. Louis Rams. “It’s more of a quick reaction to a choreographed play from the offense. We’re not saying this is the answer, but it’s a possible explanation.”

Past injuries to the meniscus, the primary shock absorber in the knee, affected almost all positions but was particularly damaging to defensive backs, whose rate of playing in the league decreased to 48 percent from 62 percent. Brophy said this was somewhat surprising, because meniscus surgery is rarely considered major.

“But damage to the meniscus may contribute to the development of arthritis,” he said, “and it’s possible that’s worse for players who do more reactive running like defensive backs.”

The heavy upper-body demands of blocking probably led to shoulder instability being particularly troublesome for linemen on both sides, the doctors said. Defensive linemen with histories of trouble in the labrum and elsewhere in the shoulder had their rate of playing in the league drop 13 percentage points; it dropped 10 percentage points for offensive linemen.

Brophy and Rodeo said their analysis also found that players who reached the league despite these injuries still played fewer career games than those without them, but that data was not included in the study. They also cautioned that their paper was not speaking about any specific player in this or any future draft — only that the trends were notable enough for teams to consider generally.

“There is a predictive factor,” Brophy said. “Evaluating the athletes medically has some predictive value whether and how long they play in the league, and it varies by injury and position.”

This raises the question of why, if doctors from the Giants and the Rams have data that can help make better use of draft picks, they would be allowed to publish it for all other teams to see.

“To our teams’ credit, they understand that you do research, you publish, you share with your colleagues,” Rodeo said. “When you’re across the sideline on Sunday, you don’t share secrets. But at the end of the day, you contribute to the field. It’s the right thing to do.”